Micromorphometrical analyses of five different ultrasonic osteotomy devices at the rabbit skull

Objectives: The recently introduced ultrasonic osteotome procedure is an alternative to conventional methods of osteotomy. The aim of the present study was to establish the differences between five recently introduced ultrasonic osteotomes and to perform micromorphological and quantitative roughness analyses of osteotomized bone surfaces. Materials and methods: Fresh, standard-sized bony samples were taken from a rabbit skull using the following ultrasonic osteotomes: the Piezosurgery (R) 3 with insert tip OT7, Piezosurgery (R) Medical with insert tip MT1-10, Piezon Master Surgery (R) with insert tip SL1, VarioSurg (R) with inert tip SG1, and Piezotome 2 with insert tip BS1 II. The required duration of time for each osteotomy was recorded. The prepared surfaces were examined via light microscopy, environmental surface electron microscopy (ESEM), and confocal laser scanning microscopy (CLSM). Results: All of the investigated piezoelectric osteotomes preserved the anatomical structure of bone. The mean roughness values of the osteotomized bone edge obtained using the investigated piezoelectric osteotomes were as follows: 2.47 mu m (Piezosurgery (R) 3), 9.79 mu m (Piezosurgery (R) Medical), 4.66 mu m (Piezon Master Surgery (R)), 6.38 mu m (VarioSurg (R)), and 6.06 mu m (Piezotome 2). Significantly higher roughness values were observed when using the Piezosurgery (R) Medical in comparison with those achieved by the Piezosurgery (R) 3 (P<0.0001) and Piezon Master Surgery (R) (P=0.002). Different osteotomy durations were achieved using the different piezoelectric osteotomes: 144 s (Piezosurgery (R) 3), 126 s (Piezosurgery (R) Medical), 142 s (Piezon Master Surgery (R)), 149 s (VarioSurg (R)), and 137 s (Piezotome 2). Conclusions: In the present study, micromorphological differences following the use of various ultrasonic devices were clearly identified. According to this study, it can be concluded that the power and the composition of the teeth of the insert tip might impact procedure duration and cutting qualities.